Organizational justice, trust, and identification and their effects on organizational commitment in hospital nursing staff

BACKGROUND It is of importance and urgency for hospitals to retain excellent nursing staff in order to improve patient satisfaction and hospital performance. However, it was found that simply increasing the salary is not the best method to resolve the problem of lacking nursing staff; it is necessary to focus on the impact of non-monetary factors. The delicate relationship between organizational justice, organizational trust, organizational identification, and organizational commitment requires investigation and clarification from more studies if application in nursing practice is to be expected. Therefore, this study was to investigate how the organizational justice perception could affect nurses' organizational trust and organizational identification, and whether the organizational trust and organizational identification could encourage nurses to willingly remain in their jobs and commit themselves to the hospitals. METHODS A cross-sectional design was used. Questionnaires were distributed in 2013 to a convenience sample of 400 registered nurses in one teaching hospital in Taiwan: 392 were retrieved. Of these, 386 questionnaires were valid, which was a 96.5% response rate. The SPSS 17.0 and Amos 17.0 (structural equation modeling) statistical software packages were used for data analysis. RESULTS The organizational justice perceived by nurses significantly and positively affects their organizational trust (γ₁₁ = 0.49) and organizational identification (γ₂₁ = 0.58). Organizational trust (β₃₁ = 0.62) and organizational identification (β₃₂ = 0.53) significantly and positively affect organizational commitment. CONCLUSIONS Hospital managers can enhance the service concepts and attitudes of frontline nursing personnel by maximizing organizational justice, organizational trust and organizational identification. Nursing personnel would then be motivated to provide feedback to the attention and care provided by hospital management by demonstrating substantial improvements in their extra-role performance. Improved service concepts and attitudes would also facilitate teamwork among colleagues, boost the morale of the nursing faculty and reduce resignations and career changes.